Individual
MRS. ALANNA ELIZABETH LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
824 S DIAMOND ST, NAMPA, ID 83686-5960
(208) 606-0396
(208) 936-7002
Mailing address
824 S DIAMOND ST, NAMPA, ID 83686-5960
(208) 606-0396
(208) 936-7002
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
ID-1253
ID
363AM0700X
Medical Physician Assistant
Primary
PA-1253
ID
Other
Enumeration date
09/01/2015
Last updated
05/21/2024
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